INTRODUCTION: Inflatable penile prosthesis (IPP) implantation is the gold standard treatment for medically refractory erectile dysfunction. New chronic pain after IPP implantation is rarely discussed and the optimal treatment is unclear. We evaluated whether IPP re-operation for a primary indication of chronic pain improves patients' symptoms. Our secondary aim was to explore factors associated with resolution or persistence of pain after IPP reoperation. METHODS: We conducted a retrospective analysis of 315 patients who had an IPP revision or explantation at two high-volume prosthetic centers between May 2007 and May 2017. We excluded patients who had device malfunction, pain for <2 months, pain associated with infection or erosion, and patients without long-term followup data. Persistent pain was diagnosed based on patient self-report. RESULTS: A total of 31 patients met our criteria for having undergone a surgical revision (n=18) or explantation (n=13) for pain relief. Eighteen (58%) patients had persistent pain despite surgical intervention. Only patients who had pain secondary to a device malposition improved after re-operation (n=13). A prior diagnosis of a chronic pain syndrome was associated with persistent pain despite intervention. Pain improvement was not associated with age, comorbid conditions, duration of implant, or the number of surgical revisions performed. CONCLUSIONS: Surgical intervention for chronic penile prosthesis pain is unlikely to relieve symptoms, particularly for patients with chronic pain disorders. Patients should be counselled that IPP reoperative procedures as a treatment for pain should be avoided unless the device is identified to be malpositioned, and consideration of alternative therapeutic options may be more beneficial.
INTRODUCTION: Inflatable penile prosthesis (IPP) implantation is the gold standard treatment for medically refractory erectile dysfunction. New chronic pain after IPP implantation is rarely discussed and the optimal treatment is unclear. We evaluated whether IPP re-operation for a primary indication of chronic pain improves patients' symptoms. Our secondary aim was to explore factors associated with resolution or persistence of pain after IPP reoperation. METHODS: We conducted a retrospective analysis of 315 patients who had an IPP revision or explantation at two high-volume prosthetic centers between May 2007 and May 2017. We excluded patients who had device malfunction, pain for <2 months, pain associated with infection or erosion, and patients without long-term followup data. Persistent pain was diagnosed based on patient self-report. RESULTS: A total of 31 patients met our criteria for having undergone a surgical revision (n=18) or explantation (n=13) for pain relief. Eighteen (58%) patients had persistent pain despite surgical intervention. Only patients who had pain secondary to a device malposition improved after re-operation (n=13). A prior diagnosis of a chronic pain syndrome was associated with persistent pain despite intervention. Pain improvement was not associated with age, comorbid conditions, duration of implant, or the number of surgical revisions performed. CONCLUSIONS: Surgical intervention for chronic penile prosthesis pain is unlikely to relieve symptoms, particularly for patients with chronic pain disorders. Patients should be counselled that IPP reoperative procedures as a treatment for pain should be avoided unless the device is identified to be malpositioned, and consideration of alternative therapeutic options may be more beneficial.
Authors: Enrique Lledó-García; José Jara-Rascón; Ignacio Moncada Iribarren; Javier Piñero-Sánchez; Juan Aragón-Chamizo; Carlos Hernández-Fernández Journal: J Sex Med Date: 2015-07 Impact factor: 3.802
Authors: Jacob Lucas; Martin Gross; Faysal Yafi; Kenneth DeLay; Sarah Christianson; Farouk M El-Khatib; Mahdi Osman; Jay Simhan Journal: J Sex Med Date: 2019-12-20 Impact factor: 3.802
Authors: John McBeth; Gordon Prescott; Graham Scotland; Karina Lovell; Philip Keeley; Phil Hannaford; Paul McNamee; Deborah P M Symmons; Steve Woby; Chrysa Gkazinou; Marcus Beasley; Gary J Macfarlane Journal: Arch Intern Med Date: 2011-11-14
Authors: Arthur L Burnett; Ajay Nehra; Rodney H Breau; Daniel J Culkin; Martha M Faraday; Lawrence S Hakim; Joel Heidelbaugh; Mohit Khera; Kevin T McVary; Martin M Miner; Christian J Nelson; Hossein Sadeghi-Nejad; Allen D Seftel; Alan W Shindel Journal: J Urol Date: 2018-05-07 Impact factor: 7.450